Home-Care Equipment and Furniture
The basic durable medical equipment (DME) you may need to assist your loved one safely includes items such as a walker or cane, raised toilet seat (with or without arm rests), a bathtub seat, a bedside commode, a wheelchair, and a hospital bed.
If your parent has been in the hospital, the discharge planner or case manager may have asked you about what DME you have and arranged for items to be sent to your home or taken with you upon discharge. If you're having home-health care, the nurse or therapist can assist you in obtaining this equipment. You can also call a DME provider yourself.
Walkers, canes, raised toilet seats, commodes, and bathtub seats are purchase items by virtue of the personal nature; they are not rentable from durable medical equipment companies. They can be purchased from DME companies as well as through catalogs and drug-store chains. Medicare may reimburse for some of these, but they have restrictions. Your DME provider can advise you, as the rules change frequently. Usually you get one in a lifetime for seniors. Younger disabled persons on Medicare may qualify for more than one depending on their age. This is why it is important to find space to store the items if they are no longer presently needed but might be needed again.
The purpose of durable medical equipment is to provide safe assistance where needed, not only to the patient, but to the caregiver as well. These items should be used only as directed. Be sure you understand all directions before the delivery person leaves; if you have questions or the equipment malfunctions, call the DME company immediately.
Walkers and Canes
Walkers come in two basic styles: one that roles or wheels and one that has to be picked up and set down with each step. They are named accordingly — wheeled walker or pick-up walker. Some people slide the pick-up walker as opposed to picking it up and setting it down. Pick-up walkers are often seen with tennis-ball covers on each of their four tips. This helps give them a little more stability but also makes them slide easier. Walkers can be outfitted with trays, baskets, or bags to help carry items.
Canes can be single-point, tripod, or quad canes. The multipoint canes have a single shaft leading down to either 4' or 3' and extending from the shaft 6"–8" above the ground. These multipoint canes are adjustable in height, offer more stability, and are a step down from a walker. This means that either the person is becoming weaker but has not progressed to the point of needing more stability of a walker, or she has significantly improved in her rehabilitation to leave the walker behind and progress to a cane. Single-point canes come in various lengths and can be sawn off to be made shorter. A physical therapist or DME specialist should adjust the cane to the proper height for greatest safety and effective function.
Toilet and Bathtub Seats
There are several types of raised toilet seats and they come in a variety of heights. Some clip on to the toilet with the regular toilet seat in the upright position. These can be removed and replaced with each use so others don't have to use the raised seat. Others are more permanent, as they are attached to the seat-bolt area. Those with arm rests may or may not have legs as well and rest on top of the toilet. For most purposes, the toilet seat must be removed.
Bathtub seats or benches come in a few sizes and configurations as well. There are smaller, rectangular ones that fit inside the tub and triangular-shaped chairs that fit in the corner of a tub or stand-up shower. There are also larger ones that are set both outside and inside the tub, so the person can sit down or transfer from a wheelchair and then slide over into the tub. She would slide back over to get out and stand or transfer back to the wheelchair.
These seats and benches are made from thick molded plastic and have holes to allow water to flow through. The legs are heavy-duty aluminum and have pushbutton adjustments to raise or lower the seat.
Most often raised toilet seats are used for persons who have difficulty sitting on or rising from a standard-height toilet. They might also be transferring from a wheelchair and require a higher toilet. Handicap stalls in public restrooms often have a taller toilet to aide wheelchair patrons in transferring to and from the toilet. People who have had hip-replacement surgeries also usually require a raised toilet seat.
A bedside commode is a portable toilet that looks somewhat like an armchair and has a bucket underneath that slides in and out for emptying. The purpose is to set it near the bedside so your parent does not have to travel to the bathroom. This can be especially useful at night or if he is ill. With the bucket removed, most bedside commodes will sit on top of a toilet to provide a raised toilet seat and armrests. It is advised to put about 1" of water in the bucket so that solid matter doesn't stick and to help dilute urine. There are a number of odor-reducing products your DME provider can recommend; a little baking soda in the bucket can work quite well.
Wheelchairs
Wheelchairs can be standard, manual-push type or they may be electric and run off a battery that looks like your car battery. They should be sized to the person by height and weight. If the person sits in one for long periods of time, she should have a cushion that is specifically designed to reduce pressure and help prevent pressure sores. Wheelchairs can be rented for short-term use or purchased if the need is long term. Medicare, Medicaid, and private insurances often cover rental or purchase fees for wheelchairs, but there are many rules and regulations. Diagnosis and prognosis are important factors in determining reimbursement issues. Work with your DME provider to understand what your best options are.
Medicare is notorious for changing the rules about DME. Of course, these changes are usually dependent on rules and funding issues set by Congress in the annual budget and other legislation. Pay close attention to how your legislators vote on the issues that affect Medicare, Social Security, and other funding regarding the elder population. Listen to candidates' platforms on eldercare and health-care issues. This now directly affects you and your family. Make your vote count and your voice heard.
Hospital Beds
Hospital beds can be rented or purchased as well; again, reimbursement is tied into diagnosis and prognosis issues and your DME provider can best advise you. In general, a manual crank-type bed is the basic version and usually the one that will have the greatest reimbursement. Electric beds are more costly, but the costs should be considered carefully in terms of the type of care your parent needs.
If your parent is bedbound or requires a lot of assistance while in bed, your body is best protected by a bed that moves up and down easily so you are not bending or providing assistance at a level that places additional strain on your back.
